Current Initiatives

California Advancing and Innovating Medi-Cal

(CalAIM)

Enhanced Care Management

Enhanced Care Management (ECM) is a new statewide Medi-Cal benefit available to select populations of focus that addresses the clinical and non-clinical needs of the highest-utilizing members through intensive coordination of health and health-related services. ECM meets members wherever they are — on the street, in a shelter, in their doctor's office or at home. Members have a single lead care manager who will coordinate care and services among the physical, behavioral, dental, developmental and social services delivery systems, making it easier for them to get the right care at the right time.

Populations of focus:

  • Individuals and families experiencing homelessness
  • Adults, youth and children who are high utilizers of avoidable emergency department, hospital or short-term skilled nursing facility services
  • Adults with serious mental illness or substance use disorder
  • Children and youth with serious emotional disturbance, identified to be at clinical high risk for psychosis or experiencing the first episode of psychosis
  • Adults and youth who are incarcerated and transitioning to the community
  • Adults at risk of institutionalization and eligible for long-term care
  • Adult nursing facility residents transitioning to the community
  • Children and youth enrolled in California Children’s Services (CCS) with needs beyond CCS
  • Children and youth involved in child welfare (including those with a history of involvement in welfare and foster care up to age 26)
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    Check here for our extensive list of providers, health networks, medical groups, hospitals and pharmacies.
Claims
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  • Trainings by Topic
    View the latest model of care and other educational materials designed to help you and your staff provide care for CalOptima Health members.

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